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This weekly blog is to explore the news around the larger issues around Digital Health, data security, data privacy, AI / ML. technology, social media and related matters.
I will also try to highlight ADHA Propaganda when I come upon it.
Just so we keep count, the latest Notes from the ADHA Board were dated 6 December, 2018 and we have seen none since!
It is worth pointing out that it was only in last little while ( beginning end July 2020 ) the ADHA took down the notification regarding the most recent minutes notification. Embarrassed I guess – as they should be!
Note: Appearance here is not to suggest I see any credibility or value in what follows. I will leave it to the reader to decide what is worthwhile and what is not! The point is to let people know what is being said / published that I have come upon.
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https://journals.sagepub.com/doi/10.1177/1460458220951719
Identifying relevant information in medical conversations to summarize a clinician-patient encounter
Juan C Quiroz, Liliana Laranjo, Ahmet Baki Kocaballi, Agustina Briatore, Shlomo Berkovsky, Dana Rezazadegan, Enrico Coiera
Published August 29, 2020 Research Article
https://doi.org/10.1177/1460458220951719
Abstract
To inform the development of automated summarization of clinical conversations, this study sought to estimate the proportion of doctor-patient communication in general practice (GP) consultations used for generating a consultation summary. Two researchers with a medical degree read the transcripts of 44 GP consultations and highlighted the phrases to be used for generating a summary of the consultation. For all consultations, less than 20% of all words in the transcripts were needed for inclusion in the summary. On average, 9.1% of all words in the transcripts, 26.6% of all medical terms, and 27.3% of all speaker turns were highlighted. The results indicate that communication content used for generating a consultation summary makes up a small portion of GP consultations, and automated summarization solutions—such as digital scribes—must focus on identifying the 20% relevant information for automatically generating consultation summaries.
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https://onlinelibrary.wiley.com/doi/full/10.1111/ajr.12663
FROM THE ALLIANCE
Telehealth—Improving access for rural, regional and remote communities
First published: 28 August 2020
https://doi.org/10.1111/ajr.12663
Over the past few years, the Alliance has been advocating for improvements to digital health capability and greater access to telehealth services for rural, regional and remote communities. The Alliance has been supportive of My Health Record, e‐prescribing, secure messaging and home monitoring, for their potential to enhance health care integration and bolster coordinated care for improved health outcomes of rural, regional and remote communities.1
However, it has been the fractured implementation of these initiatives that have caused some angst amongst health professionals and consumers alike. For example, effective implementation requires a whole‐of‐Government approach that has the Australian Digital Health Agency working collaboratively with the Department of Infrastructure, Transport, Regional Development and Communications. This would ensure that the necessary infrastructure is in place to facilitate full functionality of digital health initiatives. Yet we know that not all parts of the country have the telecommunications infrastructure with sufficient bandwidth and connectivity. It is imperative that all Australians, regardless of location and treatment environment, are able to benefit from the availability of personal health information at the point of care. If not addressed, the system has the potential to increase health inequities that people in rural and remote Australia already experience.
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Facebook says Apple rejected its attempt to tell users about App Store fees
28 August, 2020 - Reuters
Facebook on Thursday told Reuters that Apple Inc rejected its attempt to tell users the iPhone maker would take a 30 pc cut of sales in a new online events feature, forcing Facebook to remove the message to get the tool to users.
Facebook said that Apple cited an App Store rule that bars developers from showing “irrelevant” information to users.
“Now more than ever, we should have the option to help people understand where money they intend for small businesses actually goes. Unfortunately Apple rejected our transparency notice around their 30% tax but we are still working to make that information available inside the app experience,” Facebook said in a statement.
Apple did not respond to a request for comment.
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The 10 riskiest Internet of Things devices in health care
By Rohan Langdon, Regional
Director, Australia and New Zealand, Forescout
Friday, 28 August, 2020
As the healthcare industry becomes more digitally enabled, this digitalisation simultaneously exposes organisations to harmful cybersecurity risks. The healthcare industry is a relatively attractive industry for cybercriminals to target due to its critical nature as well as the high value of information held by healthcare organisations. Therefore, centralised control of all connected devices is key to successful data breach prevention.
Forescout has released The Enterprise of Things Security Report, which uncovered the 10 riskiest Internet of Things (IoT) devices in health care in 2020. This study by Forescout Research Labs is the most comprehensive study of its kind within the greater cybersecurity industry to date. It assessed the risk posture of more than eight million devices deployed across five vertical industries including health care.
Forescout measured the risk of a device to an organisation by aggregating vulnerabilities, exploitability, remediation effort, matching confidence, open ports, potential communications, business criticality and whether the device is managed.
Accordingly, the top 10 riskiest IoT device attack vectors in healthcare are:
- Pneumatic tube system.
- Uninterruptible power supply (UPS).
- UL7 gateway.
- Picture archiving and communications system (PACS) archive.
- Radiotherapy system.
- Sterilisation.
- Physical access control.
- Radiology workstation.
- Heating, ventilation and air conditioning (HVAC) systems.
- Programmable logic controller (PLC).
The adoption of IoT systems within the healthcare sector is growing and, with this transformation, so is the cybersecurity risk. The riskiest healthcare device is pneumatic tube systems. This IoT device, although often considered an ancient solution, is still widespread in hospitals. Pneumatic tube systems carry thousands of sensitive lab samples and prescription medicine daily.
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https://www.gphn.org.au/events/improved-quality-life-aged-care-setting-case-health-record/
Improved Quality of Life within the Aged Care Setting: the case for My Health Record
September 9 @ 6:30 pm - 7:30 pm
ADHA Propaganda
Realise the benefits of having access to My Health Record for your residential aged care patrons. Understand your advantage in having accurate and relevant clinical information, to assist in improving quality of life, care coordination and ultimately reduce potential medication misadventures.
Please join the Australian Digital Health Agency and Western Australia Primary Health Alliance for an interactive session and a panel discussion focusing on how digital health tools (e.g. My Health Record, electronic prescribing) can support person-centred care, in-line with their wishes and goals of care. The hosts are pleased to have speakers with a range of expertise join the session, who will be able to share their experience and insights on this topic.
All healthcare providers and care workers working across primary care and in aged care facilities are welcome to attend this session.
Wednesday 9th September 2020
6.30pm – 7.30pm
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https://www.itnews.com.au/digitalnation/four-perspectives-of-digital-healthcare-in-2020-552491
Four perspectives of digital healthcare in 2020
Australia’s healthcare system is facing a major test in the form of the COVID-19 pandemic.
By
Ry
Crozier
Aug 27 2020 12:18PM
Digital technology played a key role in addressing the crisis from day one, aiding in the triage of suspected patients, contact tracing and the continued delivery of health services.
Like many sectors, health is reimagining its future state, looking at what has been achieved in the pandemic response and how that might permanently alter traditional models of patient care.
In Digital Nation 2020, iTnews explores four perspectives of digital healthcare in 2020 and beyond:
- A digital perspective from the frontlines of the COVID response
- How data analytics is helping authorities find and treat non-COVID conditions
- Making digital part of healthcare’s business-as-usual
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The pandemic’s positive impact on telehealth
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https://www.lexology.com/library/detail.aspx?g=6ef02481-bba9-48bb-a954-603b1fcd9d04
Personal data handling and processing in Australia
Legitimate processing of PII
Legitimate processing – grounds
Does the law require that the holding of PII be legitimised on specific grounds, for example to meet the owner’s legal obligations or if the individual has provided consent?
There is no such requirement under Australian law. However, the APPs provide that an APP entity may only hold, use or disclose personal information for the primary purpose for which it was collected, or any other purpose that is related to the purpose for which the information was collected. Typically, parties in Australia have a privacy policy that explains the various uses that may be made of personal information so that it can be used for multiple purposes.
Legitimate processing – types of PII
Does the law impose more stringent rules for specific types of PII?
The Privacy Act distinguishes between personal information generally and sensitive information specifically. Sensitive information includes:
- any information or opinion about an individual’s racial or ethnic origin, political opinions, membership of a political association, religious beliefs or affiliations, philosophical beliefs, membership of a professional or trade association, membership of a trade union, sexual orientation or practices, or criminal record;
- health or genetic information about an individual; and
- biometric information and templates.
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Every keystroke you make: if the boss is mining your data, should you be paid?
Peter Lewis
Former journalist, public campaigner and director of the Centre for Responsible Technology.
August 27, 2020 — 12.00am
The exchange of our labour for payment lies at the heart of our economic system, but what happens when we begin producing things of value that we can’t even see, let alone charge for?
Amid all the disruption of technology, the very nature of our employment relationships is being transformed by by the way our work is monitored, recorded and repurposed. Across the economy, there is secondary and largely hidden market in worker-generated data. It is making employers wealthier, but often at the expense of those who produce it – and to those employees' material detriment.
Keystrokes and eye movements across screens are among vast arrays of seemingly trivial data routinely collected. It is analysed to drive more intense workflows, reduce autonomy and even create the blueprint for human redundancy.
Take warehouse workers employed to move inventory and fulfil orders. Fitted up with a GPS, they become pro bono human mapmakers, providing the models for robotics to replicate their work, without the need for breaks.
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https://apo.org.au/node/307741
Measuring value in new health technology assessments: a focus on robotic surgery in public hospitals
24 Aug 2020
Publisher Deeble Institute for Health Policy Research
Resources Measuring value in new health technology assessments: a focus on robotic surgery in public hospitals 423.81 KB
This paper considers the concept of value in health technology assessments conducted in the public hospital sector, with a specific focus on robotic surgery for hip and knee replacements. This includes what constitutes value in arthroplasty care, issues around evidence and data flows, the effectiveness of local and international bodies and committees, measurement of patient outcomes and experience, appropriate funding mechanisms, encompassing an innovative culture with strong clinician leadership and ensuring equity of access.
The creation of a robotic surgery program at Metro North Hospital and Health Service in Queensland is used as an example of how robotic surgery, specifically the Mako robot for hip and knee replacements, was assessed and implemented in a major metropolitan public hospital. The case study is used to highlight key success factors, as well as limitations in identifying and implementing a new technology in the public hospital system and whether the value of the technology can be demonstrated.
Recommendations are provided for incorporation into health technology assessments to ensure that patient outcomes are considered as well as cost in order to demonstrate the value of the new technology to the whole public health system.
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Australia needs a cyber minister and a new cyber agency
Australia's cyber security community is not up to the job expected of it. It is time for an ONA-style gathering of resources.
Lesley Seebeck Contributor
Aug 26, 2020 – 2.07pm
In mid-2016, then prime minister Malcolm Turnbull appointed Australia’s first cybersecurity minister, Dan Tehan. Such appointments are important signals: they accord priority to particular issues and ostensibly a voice in government decision-making. Little wonder that industry has been calling for its reinstatement since it was vacated by Angus Taylor two years later.
While ministers with specific portfolios may be popular, there is less appetite for ensuring the actual mechanics needed to build policy capacity, enable co-ordination across government, facilitate delivery and ensure accountability. And that’s problematic: a smart, effective public service is needed to meet the promise of digital technologies while managing their dark side, cyber security.
Machinery of government (MoG) changes – the reorganisation of government functions – should not be undertaken lightly. They can be hugely disruptive. Similarly, new functions struggle: the existing system generates antibodies, especially when functions threaten established processes and power structures.
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'Mum told me to give back to the community': the young Australian creating robots for good
Grumpily washing the dishes as a 12-year-old in Cairns, Marita Cheng dreamt of building a robot that would do her chores for her. Two decades later, the former Young Australian of the Year is turning some of that dream into a reality – but the machines she’s designing help others, not herself.
August 26, 2020
There are overachievers, and then there are people like Marita Cheng, who stands in an overachieving class all her own. One winter’s day in 2008, when she was in the second year of a mechatronics course (think engineering meets robotics) at the University of Melbourne, Cheng was sitting in a lecture hall listening intently to the words of associate professor Jamie Evans. The fresh-faced lecturer was describing how he was about to take a robotics workshop at Lauriston Girls’ School, across town in Armadale, as part of a plan to encourage more young women to study engineering.
Cheng, one of maybe a handful of women in her class of more than 50, was keen to help but saw a bigger opportunity. Within a matter of weeks she’d formed a club called Robogals with four other students, and set up appointments with primary and high schools (beginning with Lauriston Girls’) hosting robotics workshops and career talks about engineering. These were so well received, Cheng soon expanded Robogals across the country and later internationally. Since then, Robogals (Cheng is still on its board) has taught more than 100,000 girls from 11 countries across 32 chapters.
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August 25, 2020 by Arash Shaghaghi
Digging your own digital grave: how should you manage the data you leave behind?
Patrick Scolyer-Gray, Research Fellow, Cyber Security, Deakin University; Arash Shaghaghi, Lecturer, Cybersecurity, Deakin University, and Debi Ashenden, Professor of Cyber Security and Human Behaviour, Deakin University
Throughout our lifetimes we consume, collate, curate, host and produce a staggering quantity of data – some by our own hand, some by others on our behalf, and some without our knowledge or consent.
Collectively, our “digital footprints” represent who we are and who we were. Our digital legacies are immortal and can impact those we leave behind.
Many of us take steps to secure our privacy while we’re alive, but there’s mounting evidence that we should be equally concerned about the privacy and security risks of our “data after death”.
Reincarnation as data
It might be tempting to think of data after death as inconsequential – after all, we’ll no longer be around to worry about it. However, Facebook and Instagram both support static “memorial” accounts for the deceased. We also know memorial pages can play an important part of the grieving process.
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Google in a pickle if it doesn’t play ball with ACCC code
This Friday looms as an industry-defining moment in the Australian media landscape.
It’s the deadline for responses to the Australian Competition & Consumer Commission’s draft mandatory code that lets Australian media players bargain with the $US1 trillion-valued Google and fellow tech giant Facebook to secure fair payment for their news content.
Media organisations say that Google’s use of their content in search results amounts to information theft and it’s time Google paid up. Thousands of journalists have lost their jobs and hundreds of media outlets have been forced to shut since the rise of the tech titans.
On the face of it, you may think Google has the upper hand in this dispute; that with 90 per cent of the desktop search market, and 98.21 per cent of the mobile search market, it can afford to play hardball and dictate the terms.
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Decision time for Google in Australia
The $US1 trillion valued Google is playing hardball with Australian media over demands it pays to use their content.
August 24, 2020
The $US1 trillion valued Google is playing hardball with Australian media over demands it pays to use their content.
The Australian Competition and Consumer Commission (ACCC) has released a draft mandatory code that lets Australian media bargain with Google and fellow tech giant Facebook to secure fair payment for news content.
Comments on the code close on Friday and then its game-on. Either Google reaches agreement with Australian news companies or it may take its bat and ball and go home. Based on its behaviour in Spain in 2014 and other parts of Europe recently, there is a strong prospect that Google will walk away from any arrangement and opt not to display news organisations’ content in search. It could decide not to rank their stories or not show story excerpts.
You may think Google has the upper hand in this dispute, that with 90 per cent of the desktop search market and 98.21 per cent of the mobile search market, it can dictate to Australian media.
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Why the CEO/CIO partnership is critical to navigating turbulent waters
SETH RAVIN
August 25, 2020
Companies are facing unprecedented turbulence. Global disruption from the pandemic mixed with global competition is creating complex, rapidly changing technology investment priorities. For many, it’s business as unusual as they find themselves in constant response mode, adapting to legislative and economic landscapes that evolve almost daily.
Many CIOs have seen their investment road maps side-railed by the pandemic, not to mention the impact of the bushfire crisis over the summer. Non-essential projects are being put on hold, some with no definitive return date.
To survive and thrive during these times and beyond, companies must have a digital core. Many CIOs have strategically shifted their focus to investing in solutions that serve customers primarily on digital platforms. For many companies, their digital infrastructure must be able to cater to a workforce which in some cases is now 100 per cent remote. Those that were already digitally platformed have made this adjustment much more nimbly than those that hadn’t invested, or had under-invested, in digital infrastructure previously.
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https://www.lexology.com/library/detail.aspx?g=fc3ba58b-8029-4cb6-bb14-85812bfd3661
Australia releases News Media Bargaining Code for Stakeholders' comments
Digital Platform Inquiry conducted by Australia in 2018-19 concluded that Google and Facebook have distorted local media and advertising markets in ways that makes it hard for publishers to monetise their content and therefore it was recommended that a code can be drafted wherein some consideration flow can be allowed from social media giants like Google, Facebook etc. to publishers of the content.[1] Thereafter the Australian Competition and Consumer Commission (ACCC) issued a statement through its Treasurer, Joshua Anthony Frydenberg, that the ACCC would be releasing draft rules around July 2020. A detailed post on Australia relying on Competition law to make tech giants like Google and Facebook to pay for content can be found here.
Now the Australian Competition and Consumer Commission has released the News Media Bargaining Code on July 31, 2020 and have asked the interested parties to provide their written submissions on the draft code due on August 28, 2020 by 5pm to the email id bargainingcode@accc.gov.au.
Draft Bill News Media Bargaining Code can be found here.
Explanatory Material on the Draft News Media Bargaining Code can be found here.
A detailed note can also be found on the official website of ACCC at https://www.accc.gov.au/focus-areas/digital-platforms/news-media-bargaining-code/draft-legislation.
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https://www.lexology.com/library/detail.aspx?g=e65bf85f-9b0b-4cdf-8272-1ed396ac2659
The cost of deceptive privacy statements: big fine for HealthEngine highlights the importance of transparency when using personal information
Online health booking platform HealthEngine has been fined AUD$2.9m for deceptive conduct relating to the disclosure of personal information, and manipulating consumer reviews.
What is HealthEngine and what happened?
HealthEngine provides an online platform that connects consumers with over 70,000 health practitioners in Australia. Up until June 2018, it also allowed consumers to review the quality and services of health practitioners. However, between 2014 and 2018 HealthEngine:
- Earned AUD$1.8m from disclosing non-health related personal information to insurance brokers without obtaining consumer consent. Information on 135,000 consumers included names, dates of birth, phone numbers and email addresses.
- Manipulated 3,000 consumer reviews by removing negative comments on health practitioners, and failing to publish an additional 17,000 reviews.
The Australian Competition and Consumer Commission (ACCC) began investigating HealthEngine in July 2018 and subsequently launched legal proceedings in the Federal Court in 2019 for misleading and deceptive conduct.
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Facebook, Twitter must do more to stop anti-vaxxer COVID-19 lies: GPs
John Davidson Columnist
Aug 24, 2020 – 3.00pm
Social media companies such as Twitter and Facebook still aren't doing enough to counter the spread of coronavirus-related misinformation and lies on their platforms, and will need to crack down on anti-vaxxers, in particular, should a COVID-19 vaccine become available, one of Australia's peak medical bodies has warned.
Allowing anti-vaccination misinformation to continue to swirl on social media would make it harder for communities to achieve "herd immunity", where sufficient people are immunised against a virus so it can no longer spread through the population, the Royal Australian College of General Practitioners said.
"Anti-vaxxer campaigning may result in us not being able to achieve herd immunity. At the best of times herd immunity is difficult to achieve without taking into account the impact of dangerous anti-vaxxer messaging," the GPs warned.
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Hub launches to support mental health of health professionals
Wednesday, 19 August, 2020
To support the mental health of frontline health workers grappling with COVID-19, Black Dog Institute has launched TEN (The Essential Network) — a multifaceted e-health hub, developed by health professionals for health professionals as part of the Australian Government's COVID-19 response.
The e-health hub connects health workers to specialist, individualised mental health advice and triaged support to ensure access to the help they need, when they need it the most.
TEN is available via a website and an app and has been developed from the Australian Government’s $1.4 million package to support the mental health and wellbeing of healthcare workers during the pandemic.
“It is hard to imagine the strain for those working in the hospitals and clinics in COVID hotspots right now. We learnt from international experience in dealing with COVID and liaised with frontline healthcare workers when designing this program,” Black Dog Institute Chief Psychiatrist Sam Harvey explained.
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Cyber security 'should be mandated' in government procurement
Tom Burton Government editor
Aug 24, 2020 – 12.00am
Cyber security should be a mandatory government procurement requirement to create an industry-wide standard and lift cyber resilience across the economy, according to a new report.
The report, commissioned by the Australian Strategic Policy Institute, calls for federal and state governments to strategically use their $20 billion annual technology spend to create a defacto benchmark for improved cyber security and hardened supply chains.
The report recommends unification of standards; a sandbox or testing environment to enable small business to test and certify their offerings; the adoption of cyber insurance; and the building of sovereign capability by encouraging Australian providers.
"Australian governments are the nation's largest spenders on ICT [information and communications technology], but they're failing to maximise the leverage that market power gives them to drive improved cyber security and more secure supply chains," the report concludes.
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https://insightplus.mja.com.au/2020/33/wading-through-misinformation-a-2020-problem/
Wading through misinformation: a 2020 problem
Authored by Jane McCredie
A LETTER appeared in mailboxes around my inner-city area last week containing vital new information with the potential to radically alter our approach to public health.
Headed “The Corona Virus is a Scam”, the letter stated germs did not cause disease and viruses did not exist. The unnamed author knew this because they had “worked in an electron microscope unit” where they had “learned to use all the equipment”.
There was only one human disease, the author stated confidently, and that was vitamin deficiency caused by the consumption of junk food. Readers were urged to stop the “medical system dictatorship” by signing petitions against forced vaccinations.
Letterboxing seems very old school in 2020. The real battles happen on social media, and in forums most readers of this publication probably never see.
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Telehealth changes risk sexual and reproductive health delivery
Authored by Deborah Bateson
WHEN COVID-19 hit Australian shores, governments and health care workers scrambled to prepare a response to the looming crisis unfolding around the globe. Like many places, including Canada, France and the UK, the Australian response in the sexual and reproductive health sector included a rapid upscaling of telehealth services.
Enhanced telehealth accessibility, funded through the Medicare rebate system, allowed people to access healthcare in their own homes through the March–May 2020 lockdown. The switch to telehealth was in line with growing international evidence of how the pandemic response has dramatically altered health care delivery in high income countries, given the imperative to provide physically distanced health care where feasible.
However, this early win for the health of Australians has been short-lived with new restrictions making telehealth inaccessible for many and leaving the nation at risk of falling behind similar countries such as Canada and France and the UK.
The 20 July federal government changes to Medicare mean Family Planning NSW, like other similar services, can no longer offer telehealth to new clients or anyone not seen face-to-face by our doctors in the past year, which represents a great many of the patients who come to us for help.
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https://www.afr.com/policy/economy/we-must-transform-fear-of-ai-future-20200820-p55nry
We must transform fear of AI future
People worry about robots taking their jobs. But unless Australia fully engages in global tech race, we will reap all the cost and none of the benefits of the digital age.
Clare O'Neil Contributor
Aug 23, 2020 – 2.31pm
Warren Buffett always has a great turn of phrase. One of the legendary investor’s maxims is: "Only when the tide goes out do you discover who’s been swimming naked."
How naked are Australia’s technology policies? Consider this: artificial intelligence will be the defining set of technologies of my lifetime. AI is estimated to deliver US$22.9 trillion to the global economy in the coming decade. Naturally, there is fierce competition between countries to get a slice of the pie.
Tianjin, a city in China with a population of about 16 million, recently announced a $22 billion AI investment. The Australian government’s current national plan is to invest $29.9 million. By head of population, we’re being outspent approximately 1000 to one – in one corner of China alone.
This embarrassing underinvestment is part of a broader problem. Consider IT skills. Deloitte estimates that 120,000 IT jobs will be created in Australia over the next six years. In that time, our education system will generate 38,000 qualified Australians. We’re set to leave 83,000 well-paying jobs of the future on the table, for no good reason.
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Comments more than welcome!
David.
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